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he number of independent physician practices in the United States is shrinking rapidly, and this trend is projected to continue. Over the next fi ve to 10 years, private practice in its traditional form

– where a single practitioner or a small number of practitioners work independently to provide patient care – will continue to evolve, and existing private practices will need to decide whether to remain independent.

Technology: A roadblock to independence? One reason why the idea of private practice is waning is technology. As electronic health records (EHRs) become the norm, practices must deploy and update this technology to survive. Truly transformative technology requires an invest- ment, and practices must have a plan in place for deployment and maintenance because upgrades are regularly required. EHRs are not the only form of technology a practice will

need in order to face the changing healthcare landscape. Busi- ness processes, such as billing, claims submission and denials management, are also becoming automated, and practices must be able to leverage technology to streamline the revenue cycle, enhance cash fl ow and remain competitive. To internally manage both EHR and practice management technology, a practice needs to have computer programmers on staff , as well as people charged with keeping up with chang- ing regulations and ensuring the practice remains compliant. Many private practices simply cannot aff ord to navigate this eff ort on their own.

Finding a path forward To help overcome these challenges, many practices are seek-

ing partnerships with larger entities, such as hospitals or group practices. T e amount of autonomy that a private practice can keep within these diff erent models varies depending on the nature of the partnership. For those practices wishing to maintain some level of in- dependence, it may be benefi cial to seek a partner that takes

12 May 2013

Debbie Redd is president and CEO at Capital Women’s Care. For more on NextGen Healthcare: www. rsleads.com/305ht-201

responsibility for the business operations of the practice with- out impacting the clinical side. T is is how Capital Women’s Care functions. We are a multi-site obstetrics/gynecology group located throughout Virginia, Maryland and Washing- ton, D.C. Fourteen years ago, we had 27 providers working in several practices throughout the area. Today, we have more than 140. T rough our corporate offi ce, we leverage technol- ogy to manage each practice’s billing, EHR technology and human resources, providing the practice with a stable business infrastructure upon which to grow.

For those practices wishing to maintain some level of independence, it may be benefi cial to seek a partner that takes responsibility for the business operations of the practice without impacting the clinical side.

When partnering with us, a practice agrees to share our name and adopt our business infrastructure; however, the prac- tice remains clinically independent. T e corporate offi ce is not involved in setting clinical policy, implementing universal care protocols, defi ning treatment methods or in any way govern- ing how physicians practice medicine. In this way, physicians can remain clinically autonomous and still be part of a bigger organization, protecting the individual practice from a large technology spend and the roller coaster of requirements and regulations that exists today. Because of size, a large group practice like Capital Women’s

Care has success in negotiating fair-priced contracts and gain- ing more attention from healthcare technology companies. A small private practice would probably not receive competitive rates or may not even be eligible to partner with a large in- tegrated technology fi rm. Such fi rms tend to focus on larger organizations that cater to multiple physicians.